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Old 08-28-2019, 01:52 PM   #1
BowSlayer
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Default Health Insurance rip off

So the wife was having severe abdominal pain this morning so I took her to her doctor. The doctor ordered a CT Scan and sent us across town to get it. When we get here the lady tells us that we havenít met our insurance deductible and out of pocket yet so we need to pay $2689.00 for the scan. I told them that I had one done with no insurance and it wasnít that much. She says ďItís cheaper without insuranceĒ. So I tell her Iíll pay the ďwithout insurance priceĒ. Total out the door is $400. This whole insurance game is ridiculous and really ticks me off. If you have anything done and have insurance make sure you ask them for the cash price too. They were going to let us pay $500 today and pay the balance out monthly if we filed on insurance. Didnít file and got out for $400 total. Grrrrr
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Old 08-28-2019, 01:58 PM   #2
DaveC
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Wow, nice of her to give you that option upfront

Good lesson for the rest of us.
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Old 08-28-2019, 01:59 PM   #3
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I’m a cash pay patient also and it’s been ok so far. Only worry I have is if it’s something major, it would be beneficial to have it.
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Old 08-28-2019, 02:00 PM   #4
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That's crazy but I seem to hear this same situation alot these days.
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Old 08-28-2019, 02:06 PM   #5
Huntsman27
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And there is the problem with our healthcare system. why is a facility willing to accept $400.00 and presumably be profitable for this service but must be paid much much more to file it on insurance. I understand there is a cost to file a claim and have to wait for your money but that is ridiculous.
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Old 08-28-2019, 02:09 PM   #6
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I had a similar experience, wife is pregnant and needed some extra ultrasounds because she is old (35). With insurance it's a little more than $1500. If you pay cash, $248.
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Old 08-28-2019, 02:17 PM   #7
hooligan
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Obamacare


Prescriptions are the same way. My Kroger is really good about checking both options and many times has told us how much cheaper it is to not run through insurance
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Old 08-28-2019, 02:56 PM   #8
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Thanks Barak.
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Old 08-28-2019, 03:00 PM   #9
Mr. Whiskers
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I have catastrophic insurance. Always pay cash. Much cheaper
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Old 08-28-2019, 03:12 PM   #10
abilliott
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Pre-paying with cash for delivering a child is the same way. Waaay cheaper than what they will hit your insurance for if you had coverage for delivery. $4,500 vs $45,000 roughly??? Doesn't make any sense.
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Old 08-28-2019, 03:22 PM   #11
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Auto body shops are the same way.


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Old 08-28-2019, 03:23 PM   #12
JHT
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Originally Posted by Mr. Whiskers View Post
I have catastrophic insurance. Always pay cash. Much cheaper
What kind of policy do you have? Deductible?
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Old 08-28-2019, 03:24 PM   #13
Freer
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I have catastrophic insurance. Always pay cash. Much cheaper
I'd like to hear some details on this. How much is the premium, deductible, ect.
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Old 08-28-2019, 03:29 PM   #14
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Originally Posted by Huntsman27 View Post
And there is the problem with our healthcare system. why is a facility willing to accept $400.00 and presumably be profitable for this service but must be paid much much more to file it on insurance. I understand there is a cost to file a claim and have to wait for your money but that is ridiculous.
Because, you are paying for yourself and the 10 others who don't have insurance.
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Old 08-28-2019, 03:30 PM   #15
kmitchl
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Originally Posted by BowSlayer View Post
So the wife was having severe abdominal pain this morning so I took her to her doctor. The doctor ordered a CT Scan and sent us across town to get it. When we get here the lady tells us that we havenít met our insurance deductible and out of pocket yet so we need to pay $2689.00 for the scan. I told them that I had one done with no insurance and it wasnít that much. She says ďItís cheaper without insuranceĒ. So I tell her Iíll pay the ďwithout insurance priceĒ. Total out the door is $400. This whole insurance game is ridiculous and really ticks me off. If you have anything done and have insurance make sure you ask them for the cash price too. They were going to let us pay $500 today and pay the balance out monthly if we filed on insurance. Didnít file and got out for $400 total. Grrrrr
I've done the same thing. Needed a MRI, My cost with insurance was $900. Cash price was $300. Guess which one I chose.
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Old 08-28-2019, 03:35 PM   #16
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****, i'm thinking i should have brought this up when i got my last MRI. $1600 out of my pocket b/c i hadn't met my deductible.

thanks for the tip.
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Old 08-28-2019, 03:39 PM   #17
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The middle man always squeezes the working man.


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Old 08-28-2019, 03:42 PM   #18
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Insurance is a racket. Always has been. Can't afford it myself. To put me on my wife's insurance would cost her half of what she makes every month. Without insurance you get FINED at the end of the year which they take out of your return if you get one. That's extortion any way you word it. Yall got by cheap on the mri's. Had one doe and cost 9k
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Old 08-28-2019, 04:53 PM   #19
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Thanks Barak.
Egg Zachary
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Old 08-28-2019, 05:52 PM   #20
TeamAmerica
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Quote:
Originally Posted by Louis View Post
Insurance is a racket. Always has been. Can't afford it myself. To put me on my wife's insurance would cost her half of what she makes every month. Without insurance you get FINED at the end of the year which they take out of your return if you get one. That's extortion any way you word it. Yall got by cheap on the mri's. Had one doe and cost 9k


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Old 08-28-2019, 06:05 PM   #21
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Quote:
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Insurance is a racket. Always has been. Can't afford it myself. To put me on my wife's insurance would cost her half of what she makes every month. Without insurance you get FINED at the end of the year which they take out of your return if you get one. That's extortion any way you word it. Yall got by cheap on the mri's. Had one doe and cost 9k
The reason for high deductibles and premiums is because the government has forced insurance companies to cover every person who applies without them being able to underwrite the risk.

So if a person is getting ready to have a transplant for example it can run well over a million dollars. If that person applies with an insurance company for coverage that company has no choice but to cover them - they cannot deny coverage and they must cover pre existing conditions - so the result is that the person pays maybe $600 bucks a month in premium and the insurance company is on the hook for over a million. Not a good business model for any business. This is why your choices of companies and coverage has shrunk dramatically in recent years - insurance companies are bailing out of the individual health insurance business every day -

The entire system is a mess for sure -
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Old 08-28-2019, 06:12 PM   #22
Preacher Man
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^^^ This right here. It's now mandatory that insurance companies cover pre-existing conditions. The healthy are now paying for the unhealthy.

Faith based health cost sharing programs are not under these rules. They are exempted, which is why they don't charge you a freaking mortgage payment!

I started a small business about a year ago. A classic health insurance plan was going to cost me so much that I wouldn't have been able to go into business for myself without a better alternative.

Its a flat out joke
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Old 08-28-2019, 06:27 PM   #23
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It’s all a scam.
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Old 08-28-2019, 06:28 PM   #24
Spoiled_TN_boy
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API physical therapy charged my Insurance company $498/visit for 1hr . I didn't get a bill for 3 months after I stopped going. Ridiculous crap. Good thing I stopped after 3 visits, otherwise my bill would have been astronomical.
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Old 08-28-2019, 06:31 PM   #25
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Sometimes if they know you have insurance they won’t let you pay cash price. Experienced that before.
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Old 08-28-2019, 06:34 PM   #26
Pineywoods
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Quote:
Originally Posted by Louis View Post
Insurance is a racket. Always has been. Can't afford it myself. To put me on my wife's insurance would cost her half of what she makes every month. Without insurance you get FINED at the end of the year which they take out of your return if you get one. That's extortion any way you word it. Yall got by cheap on the mri's. Had one doe and cost 9k
Same here. Never had it, never could afford it. I could buy another house for what insurance costs. My wife had it through the school district for her and the kids but it has gone up every year. It finally went up enough this year that we canceled it. It is an absolute racket. The out of pocket deductibles are so high that it wouldn't matter if we did have it.
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Old 08-28-2019, 06:35 PM   #27
BowSlayer
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Originally Posted by ladybluearm View Post
Sometimes if they know you have insurance they wonít let you pay cash price. Experienced that before.


It would have gotten ugly if that had happened.
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Old 08-28-2019, 06:39 PM   #28
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Quote:
Originally Posted by Louis View Post
Insurance is a racket. Always has been. Can't afford it myself. To put me on my wife's insurance would cost her half of what she makes every month. Without insurance you get FINED at the end of the year which they take out of your return if you get one. That's extortion any way you word it. Yall got by cheap on the mri's. Had one doe and cost 9k
I thought Trump had eliminated the insurance mandate? Do you still have to pay a penalty for not having health insurance?

We are all covered on my wife's policy, and JUST ME is over $1000 a month. That's with absolutely no medical questions, age considerations or anything. Any spouse cost over $1000 a month to add. And, it is a high deductible plan. I believe we pay everything until we meet the $13,500 deductible. Thanks Obama!
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Old 08-28-2019, 06:47 PM   #29
meltingfeather
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dats nuts
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Old 08-28-2019, 07:06 PM   #30
M16
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I thought Trump had eliminated the insurance mandate? Do you still have to pay a penalty for not having health insurance?
He did but it doesnít go into effect until this tax year.
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Old 08-28-2019, 07:27 PM   #31
Preacher Man
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Trump ended the mandate as Jan 1, 2019.
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Old 08-28-2019, 07:28 PM   #32
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Yall got by cheap on the mri's. Had one doe and cost 9k
I can beat that.

I had a MRI last year and the hospital billed the insurance $67,312. Insurance only paid them $3600 which was still too much.
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Old 08-28-2019, 07:39 PM   #33
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Originally Posted by Pineywoods View Post
Same here. Never had it, never could afford it. I could buy another house for what insurance costs. My wife had it through the school district for her and the kids but it has gone up every year. It finally went up enough this year that we canceled it. It is an absolute racket. The out of pocket deductibles are so high that it wouldn't matter if we did have it.
Same situation. Wife and kids on her district policy. to add me would be an addtitional 800 monthly.I ALMOST had her cancel it this year but she chickened out in anxiety the last day of enrollment last week and signed up for it.
We pay cash for everything anyway because the deductible is still like 5500 and thats a ton of dr visits to meet.
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Old 08-28-2019, 07:50 PM   #34
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My best friend is a doctor and the stories I could tell you about health insurance. We should have never let insurance companies into the medical field! JMO!
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Old 08-28-2019, 09:32 PM   #35
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Quote:
Originally Posted by BowSlayer View Post
So the wife was having severe abdominal pain this morning so I took her to her doctor. The doctor ordered a CT Scan and sent us across town to get it. When we get here the lady tells us that we havenít met our insurance deductible and out of pocket yet so we need to pay $2689.00 for the scan. I told them that I had one done with no insurance and it wasnít that much. She says ďItís cheaper without insuranceĒ. So I tell her Iíll pay the ďwithout insurance priceĒ. Total out the door is $400. This whole insurance game is ridiculous and really ticks me off. If you have anything done and have insurance make sure you ask them for the cash price too. They were going to let us pay $500 today and pay the balance out monthly if we filed on insurance. Didnít file and got out for $400 total. Grrrrr

This is insane!
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Old 08-28-2019, 10:26 PM   #36
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Thanks for the tips.

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Old 08-28-2019, 10:31 PM   #37
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Originally Posted by Huntsman27 View Post
And there is the problem with our healthcare system. why is a facility willing to accept $400.00 and presumably be profitable for this service but must be paid much much more to file it on insurance. I understand there is a cost to file a claim and have to wait for your money but that is ridiculous.
Because insurance companies tend to bicker and ***** and delay payment as long as possible, there fore hospitals and doctors are gonna stick it to them. Thatís just my opinion having dealt with claims of my own. Kinda like being a contractor in the oilfield (which I have lots of experience with), prices are higher when you know youíll wait on your money from 90 to 120 days.
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Old 08-28-2019, 10:48 PM   #38
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Originally Posted by Native Texan View Post
I can beat that.

I had a MRI last year and the hospital billed the insurance $67,312. Insurance only paid them $3600 which was still too much.
This is what Iíve never understood. Most insurance companies have a negotiated price on services by medical providers already established. Why the heck do they bill an over inflated price to insurance & then you get the letter showing how much was billed but insurance only pays the contracted price?
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Old 08-28-2019, 11:18 PM   #39
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I had a surgery earlier this year. My hospital, surgeon, and anesthesiologists were all in my network. I was very diligent in making sure of this. I paid about 3k total for the entire procedure which meet my out-of-pocket max for the year. This was in January. Last week I got a letter from the surgeon saying that I owed the nurse 2.5k cause she was out of my network.

There has to be some legal document I can carry to all my doctors/surgeons/etc saying that I do not consent to treatment from any out-of-network providers (except for life threatening situations).
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Old 08-28-2019, 11:32 PM   #40
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A friend had a 2 stints put in 7 years ago and with insurance it would have been $84,000. He paid it out a hundred a month and it cost him $16,000.
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Old 08-28-2019, 11:59 PM   #41
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Quote:
Originally Posted by Nplattii View Post
I had a surgery earlier this year. My hospital, surgeon, and anesthesiologists were all in my network. I was very diligent in making sure of this. I paid about 3k total for the entire procedure which meet my out-of-pocket max for the year. This was in January. Last week I got a letter from the surgeon saying that I owed the nurse 2.5k cause she was out of my network.

There has to be some legal document I can carry to all my doctors/surgeons/etc saying that I do not consent to treatment from any out-of-network providers (except for life threatening situations).
This is "one" of my pet peeves with in/out network.

8 months is just too long to bill & 2.5K to one nurse for one procedure...BS. I really hate the way insurance has evolved into.
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Old 08-29-2019, 01:45 AM   #42
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I had a surgery done 7 years ago . Insurance was billed almost 60g . Sister had the same surgery paid cash was less then 8grand .
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Old 08-29-2019, 05:13 AM   #43
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So what's the point of paying for insurance if you can pay less in cash for doctor visits and minor medical procedures? Seams to me that unless you have sickly family members you would be far ahead to pocket/save the high premiums. You can always sign up for insurance with pre-existing conditions.

Obama care is doing more damage to the middle class folks than anyone could conceive... Along with the medical industry lobbyist and crooked politicians this great country is doomed to fail.
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Old 08-29-2019, 06:45 AM   #44
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Quote:
Originally Posted by Drycreek3189 View Post
Because insurance companies tend to bicker and ***** and delay payment as long as possible, there fore hospitals and doctors are gonna stick it to them. Thatís just my opinion having dealt with claims of my own. Kinda like being a contractor in the oilfield (which I have lots of experience with), prices are higher when you know youíll wait on your money from 90 to 120 days.
Boy howdy, I can tell you some stories on that. One of the worst was a waste water hauling company out of Pennsylvania, 180 days to pay. Everything they bought I charged an extra 10% fuel surcharge.

Back to the insurance beef, I had to visit the ER at Connolly Memorial in Floresville a few weeks ago when I tore my bicep tendon. Before I was admitted they hit me for 200.00. I paid but told the lady that is nuts and she said yes and you will be here at least 3 hours, we make sure of that.
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Old 08-29-2019, 07:30 AM   #45
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Sounds like a hospital rip off to me.
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Old 08-29-2019, 07:55 AM   #46
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Insurance companies are no different from a deranged person holding a gun to your head and saying give me all your money. I despise insurance companies.
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Old 08-29-2019, 08:19 AM   #47
kyle1974
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My wife was charged $10 for a ludens cough drop 15 years ago while in the hospital delivering our son. It wasnít an insurance company that made them so that.
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Old 08-29-2019, 08:28 AM   #48
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Originally Posted by Nplattii View Post
I had a surgery earlier this year. My hospital, surgeon, and anesthesiologists were all in my network. I was very diligent in making sure of this. I paid about 3k total for the entire procedure which meet my out-of-pocket max for the year. This was in January. Last week I got a letter from the surgeon saying that I owed the nurse 2.5k cause she was out of my network.

There has to be some legal document I can carry to all my doctors/surgeons/etc saying that I do not consent to treatment from any out-of-network providers (except for life threatening situations).


This drives me crazy. When my wife delivered our son we made sure the hospital, doctor, etc. were all in network. The specialist the hospital sent into our room to check our sons ears and eyes was not in our network and we had to pay out of pocket. We were never made aware of this, given any options, etc. I donít see how they can legally do this type of stuff.


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Old 08-29-2019, 08:41 AM   #49
Huntsman27
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Quote:
Originally Posted by Drycreek3189 View Post
Because insurance companies tend to bicker and ***** and delay payment as long as possible, there fore hospitals and doctors are gonna stick it to them. Thatís just my opinion having dealt with claims of my own. Kinda like being a contractor in the oilfield (which I have lots of experience with), prices are higher when you know youíll wait on your money from 90 to 120 days.
PPO contracts have language in them about paying within a certain time frame on "clean claims". My opinion is that PPO contracts are negotiated as a percentage off billed charges not a fixed dollar amount for a service which is why there are such huge discrepancies in price between providers. there could be two facilities in the same city and both in the same networks. they have both agreed to 60% discount off billed charges for an MRI but one facility's billed charges are $2,500 and the other is $4,000. You still get 60% off but obviously one is a much better deal. Again, my opinion is this is the problem, there is no transparency in billing practices, insurance companies and facilities need each other and the way PPO contracts work leave all the power in the hands of the facility.
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Old 08-29-2019, 08:45 AM   #50
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Originally Posted by Freer View Post
I'd like to hear some details on this. How much is the premium, deductible, ect.
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